Hi I am suffering from social anxiety disorder since long. My psychiatrist tried different combination of medicines but nothing worked notable. Finally, Bupron XL 300 and Panazep (25/0.5 mg) combination worked for me the most. I am taking this combination of these medicines since January 2015 and regularly since October 2015. Recently I gone through regular medical checkup and found elevated liver enzymes - Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT), in my blood stream. I am diagnosed with no signs of Hepatitis (A/B/C), though a bit fatty liver and a small Kidney stone. I am a healthy person with no physical signs of any liver issue. I am developed little fat in my stomach in last couple of years but feel healthy. I don't drink, smoke and am pure vegetarian. I eat home-made healthy food mostly with balanced nutrition diet. I want to understand the possible causes behind my elevated liver enzymes and what could be the possible results of this situation? Is it happening due to my long-term usage of anti-anxiety medication. Do I need to stop my anti-anxiety medication? If I do so, I would be in big trouble as this will directly affect my social and working life. If this is necessary to stop medication, what are possible alternatives for me to control my social-anxiety? Please help and advise. I am worried as I have a family dependent on me only. Thanks in advance. Medicines: Bupron- Bupropion Hydrochloride Modified Release Tablets Panazep- Paroxetine Hydrochloride IP 25 mg + Clonazepam IP 0.5 mg Dosages: 1 Bupron + 1 Panazep daily in the morning with empty stomach before leaving to office Elevated Liver Enzymes: Aspartate Aminotransferase (AST or SGOT) as 169 U/L Alanine Aminotransferase (ALT or SGPT) as 113 U/L.
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Hi, a psychiatrist will be able to answer your concerns with regard to the medicines aspect of your question. Liver enzymes can also be elevated when we have grade 1 fatty liver which can also happen due to lifestyle related issues such as sedentary lifestyle, stress, less exercise and weight gain. In view of your kidney stone, it would be nice to consult a general physician for the same. As far as Social Anxiety is concerned, it can also be addressed by counselling or therapy with a psychologist. Usually social anxiety arises due to over alertness to social cues from others such as 'what will people think about me' possible low self confidence or incorrect perceptions about self or others which starts impacting our functioning in daily life. While medications help to address the physiological aspect of anxiety related symptoms, counselling or therapy helps by addressing our thought processes and tackling the problem from its root cause and can empower you for life. Hope this helps. Take care.
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